Eating disorders can affect anyone – leading to negative thoughts around food and an unhealthy obsession with eating, exercise, and body weight or shape. Eating disorders have the highest mortality rate of any mental health issues. Up to 20 per cent of those suffering from anorexia die from suicide and health complications. Against the backdrop of the global pandemic, eating disorders have thrived amidst the fear and uncertainty, along with the lack of physical activity and weight gain during periods of lockdown.

In the subject “Mental Health Disorders Across the Lifespan”, taught in James Cook University (JCU) in Singapore’s Master of Psychology (Clinical), students have the opportunity to discuss in depth and learn more about eating disorders – with emphasis on anorexia nervosa, bulimia nervosa, and binge eating disorder – over a full-day workshop. Students discover the cultural context of eating disorders, for example, influence of urbanisation and Western ideals on the development of eating disorders in Asian context. Several studies suggest that body dissatisfaction is increasingly pervasive among certain Singaporeans, such as university students and Singaporean-Chinese schoolgirls.

Additionally, one of the activities in the workshop includes painstakingly documenting every food intake detail in a day, to mirror the treatment experience of someone suffering from an eating disorder. “I think it is important for future clinicians, who have not been exposed to eating disorders yet, to be able to not only read clinical books and case studies, but to get access to the inner world and struggles of someone with an eating disorder,” says Dr Alla Demutska, Lecturer in Clinical Psychology at JCU in Singapore.

Students will also learn to understand how eating disorders can manifest differently in different genders, and the physiological effects of eating disorders. It can be hard to identify if someone you know is suffering from an eating disorder. After all, the weight loss or gain is not always noticeable. Dr Demutska shares, “There are various behavioural, physical and psychological warning signs – including dieting behaviours and/or changes in food behaviours such as excluding certain food types or an overconcern with ‘healthy eating’; food hoarding; indication that the person is vomiting or using laxatives; and excessive exercise.”

She adds, “The person suffering from the eating disorder might feel anxious around food and mealtimes, starts avoiding socialising when it involves food, or stops socialising altogether. Often women with eating disorders experience changes in menstrual cycle or stop menstruating. Those with eating disorders often have low self-esteem and feel unhappy about their body shape and believe that they are fat even if they are extremely thin. Often there are signs of anxiety and depression such as low mood, difficulty concentrating, lack of motivation and not enjoying previously-liked activities.”

Essentially, eating disorders can cause a wide range of issues – including headaches, dizziness, low iron levels, dry skin and lips, brittle nails, irregular heartbeat, abdominal pains, loss of libido, infertility, kidney failure, osteoporosis, muscle loss or weakness, and more. In patients with anorexia, the body’s survival instincts kick in and draw fat from everywhere to function – even the brain – leading to slowed thinking, increased rigidity and impacts to memory.

The road to recovery is crucial, but not easy. Dr Demutska says, “Eating disorders are complex conditions, and require professional help. It is often difficult for those suffering from eating disorders to start treatment due to feelings of shame and fear, or not acknowledging that they have a problem. The earlier the treatment starts, the better the chances of a successful outcome are.”

Some people might benefit from standalone therapies (which involve working with only one professional), but more often treatment involves a multidisciplinary approach that includes dieticians, doctors, psychologists and other professionals, to treat for the physical, psychological, nutritional and functional aspects of the eating disorders. Through case studies and vignettes in the workshop on eating disorders, JCU students learn to understand the clients in the case studies and their needs, and devise treatment plans accordingly.

Dealing with an eating disorder can be frustrating and disheartening. It is important to reach out and seek help. After all, eating disorders thrive in isolation.

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Media: Pinky Sibal [email protected]